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Traumatic facet joint dislocation in Western Australia

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Abstract

Introduction

Facet joint dislocation is a traumatic injury, which frequently results in devastating clinical outcomes. In Western Australia (WA), Royal Perth Hospital (RPH) provides a statewide Spinal Trauma Service and accepts all referrals from the entirety of the state. The economies of distance in WA mean that there is often a considerable delay between initial presentation at the peripheral hospital and enlocation of the dislocation in Perth. This study aims to identify any prejudicial clinical outcomes as a consequence of this delay.

Methods

This study retrospectively examines all facet joint dislocations that presented to RPH between in a 46-month period. Data were collected on the demographics of patients, mechanism of injury, neurological assessment at presentation of injury based on the American spinal injury association (ASIA), initial presentation to RPH, post-surgical reduction and post rehabilitation.

Results

Over this time there were 23 urban patients and 28 rural patients. In the urban group, 18 patients had a final ASIA score of D or E while 5 patients had a final ASIA score of A, B or C. In the rural group, 17 patients had a final ASIA score of A, B or C while 11 patients had a final ASIA score of D or E.

Conclusion

This study confirms the challenges of management of these injuries in a large geographical area, with a centralised spinal trauma service. Generally, facet joint dislocations that had delayed reductions had a poorer outcome. We hope that the proposed protocol would deliver better management of these injuries.

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References

  1. World report on disability (2011) World Health Organisation

  2. Delamarter RB, Sherman J, Carr JB (1995) Pathophysiology of spinal cord injury. Recovery after immediate and delayed decompression. J Bone Joint Surg Am 77(7):1042–1049

    CAS  PubMed  Google Scholar 

  3. Carlson GD, Gorden CD, Oliff HS, Pillai JJ, LaManna JC (2003) Sustained spinal cord compression: part I: time-dependent effect on long-term pathophysiology. J Bone Joint Surg Am 85-A(1):86–94

    PubMed  Google Scholar 

  4. Lee AS, MacLean JC, Newton DA (1994) Rapid traction for reduction of cervical spine dislocations. J Bone Joint Surg Br 76(3):352–356

    CAS  PubMed  Google Scholar 

  5. Newton D, England M, Doll H, Gardner BP (2011) The case for early treatment of dislocations of the cervical spine with cord involvement sustained playing rugby. J Bone Joint Surg Br 93(12):1646–1652

    Article  CAS  PubMed  Google Scholar 

  6. Wilson JR, Singh A, Craven C, Verrier MC, Drew B, Ahn H et al (2012) Early versus late surgery for traumatic spinal cord injury: the results of a prospective Canadian cohort study. Spinal cord 50(11):840–843

    Article  CAS  PubMed  Google Scholar 

  7. Furlan JC, Noonan V, Cadotte DW, Fehlings MG (2011) Timing of decompressive surgery of spinal cord after traumatic spinal cord injury: an evidence-based examination of pre-clinical and clinical studies. J Neurotrauma 28(8):1371–1399

    Article  PubMed  PubMed Central  Google Scholar 

  8. Walton G (1893) A new method of reducing dislocation of the cervical vertebrae. J Nerv Ment Dis 20:609

  9. Crutchfield WG (1954) Skeletal traction in treatment of injuries to the cervical spine. J Am Med Assoc 155(1):29–32

    Article  CAS  PubMed  Google Scholar 

  10. Evans D (1961) Reduction of cervical dislocations. J Bone Joint Surg Br 43B:552–555

    Google Scholar 

  11. Kleyn PJ (1984) Dislocations of the cervical spine: closed reduction under anaesthesia. Paraplegia 22:271–281

    Article  CAS  PubMed  Google Scholar 

  12. Eismont FJ, Arena MJ, Green BA (1991) Extrusion of an intervertebral disc associated with traumatic subluxation or dislocation of cervical facets: case report. J Bone Joint Surg Am 73(10):1555–1560

    CAS  PubMed  Google Scholar 

  13. Berrington NR, van Staden JF, Willers JG, van der Westhuizen J (1893) Cervical intervertebral disc prolapse associated with traumatic facet dislocations. Surg Neurol 40(5):395–399

    Article  Google Scholar 

  14. Hadley MN, Fitzpatrick BC, Sonntag VK, Browner CM (1992) Facet fracture-dislocation injuries of the cervical spine. Neurosurgery 30(5):661–666

    Article  CAS  PubMed  Google Scholar 

  15. Doran SE, Papadopoulos SM, Ducker TB, Lillehei KO (1993) Magnetic resonance imaging documentation of coexistent traumatic locked facets of the cervical spine and disc herniation. J Neurosurg 79(3):341–345

    Article  CAS  PubMed  Google Scholar 

  16. Rizzolo SJ, Piazza MR, Cotler JM, Balderston RA, Schaefer D, Flanders A (1991) Intervertebral disc injury complicating cervical spine trauma. Spine 16(6 Suppl):S187–S189

    Article  CAS  PubMed  Google Scholar 

  17. Schaefer DM, Flanders A, Northrup BE, Doan HT, Osterholm JL (1991) Magnetic resonance imaging of acute cervical spine trauma. Correlation with severity of neurologic injury. Spine 14(10):1090–1095

    Article  Google Scholar 

  18. Vaccaro AR, Falatyn SP, Flanders AE, Balderston RA, Northrup BE, Cotler JM (1999) Magnetic resonance evaluation of the intervertebral disc, spinal ligaments, and spinal cord before and after closed traction reduction of cervical spine dislocations. Spine 24(12):1210–1217

    Article  CAS  PubMed  Google Scholar 

  19. Gelb DE, Hadley MN, Aarabi B, Dhall SS, Hurlbert RJ, Rozzelle CJ et al (2013) Initial closed reduction of cervical spinal fracture-dislocation injuries. Neurosurgery 72(Suppl 2):73–83

    Article  PubMed  Google Scholar 

  20. Harrington JF, Likavec MJ, Smith AS (1991) Disc herniation in cervical fracture subluxation. Neurosurgery 29(3):374–379

    Article  CAS  PubMed  Google Scholar 

  21. Cotler HB, Miller LS, DeLucia FA, Cotler JM, Dayne SH (1987) Closed reduction of cervical spine dislocations. Clin Orthop 214:185–199

    PubMed  Google Scholar 

  22. Mahale YJ, Silver JR (1992) Progressive paralysis after bilateral facet dislocation of the cervical spine. J Bone Joint Surg Br 74B:219–223

    Google Scholar 

  23. Yashon D, Tyson G, Vise WM (1975) Rapid closed reduction of cervical fracture dislocations. Surg Neurol 4:513–514

    CAS  PubMed  Google Scholar 

  24. Farmer J, Vaccaro A, Albert TJ, Malone S, Balderston RA, Cotler JM (1998) Neurologic deterioration after cervical spinal cord injury. J Spinal Disord 11(3):192–196

    Article  CAS  PubMed  Google Scholar 

  25. Rosenfeld JF, Vaccaro AR, Albert TJ, Klein GR, Cotler JM (1998) The benefits of early decompression in cervical spinal cord injury. Am J Orthop 27(1):23–28

    CAS  PubMed  Google Scholar 

  26. Shrosbree RD (1979) Neurological sequelae of reduction of fracture dislocations of the cervical spine. Paraplegia 17:212–221

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Vivek Eranki.

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Eranki, V., Koul, K., Mendz, G. et al. Traumatic facet joint dislocation in Western Australia. Eur Spine J 25, 1109–1116 (2016). https://doi.org/10.1007/s00586-014-3627-x

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  • DOI: https://doi.org/10.1007/s00586-014-3627-x

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